Phone Voicemail Text Message (SMS) Email Post
Female Male Transgender Non-binary Prefer not to say Other
Yes No Prefer not to say
White Asian Mixed Black Other
British European Gypsy/Traveller Irish Other White
Chinese Bangladeshi Indian Pakistani Other Asian
Asian and White Black African and white Black Caribbean and white Other mixed
African Caribbean Other black
Arab Prefer not to say Other
Bisexual Lesbian Gay man Heterosexual/straight Prefer not to say Other
Learning disability (e.g. dyslexia) or cognitive Impairment (e.g. head injury) Longstanding illness/condition (e.g. diabetes, cancer) Mental health condition (e.g. schizophrenia, anxiety) Physical impairment/mobility issues Neuro Diverse No condition/impairment Prefer not to say Other
Yes No Prefer not to say
No religion Christian Buddhist Hindu Jewish Muslim Sikh Prefer not to say Other
Yes No
Yes No
Yes No
Yes No

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Disability Action Haringey,
Winkfield Resource Centre,
33 Winkfield Road,
Wood Green Haringey, N22 5RP
Charity Registration Number 1191762